Our Publications

Using an Interactive Voice Response Telephone System in the Assessment and Management of Symptoms in Advanced NSCLC Patients Receiving Chemotherapy

Principal Investigator: Xin Shelley Wang, M.D., M.P.H.

Optimal management of cancer-related symptoms is dependent on accurate and timely symptom assessment. This protocol is testing a novel interactive voice response (IVR) telephone system that monitors patients’ symptoms at home, and can notify their health care team when symptom severity needs intervention. Patients undergoing chemotherapy for non-small-cell lung cancer (NSCLC) will be studied. Patients will respond to programmed questions about their symptoms using the keypad of a touch-tone phone. After collecting baseline data on symptom pattern, severity and current treatment (Phase 1), the utility of feedback of patient symptoms to the health care team will be tested in a randomized trial (Phase 2). If effective, this symptom assessment system should be applicable to other settings treating cancer patients.

Specific Goals

To compare the effectiveness of an IVR telephone triage/feedback system versus an interactive voice response telephone system with assessment only in monitoring and managing symptoms in patients with advanced NSCLC

To compare differences in mood and quality of life variables of patients using the IVR triage/feedback system versus IVR assessment only

To compare the healthcare utilization (emergency visits, admissions, length of stay for hospitalizations for uncontrolled symptoms) of patients using the IVR triage/feedback system versus IVR assessment only

Methods

Patients from the thoracic service with NSCLC who are scheduled to have chemotherapy will be recruited for this study.

Phase 1 Study

The IVR system will serve as a data collection system to document symptom patterns and severity. All patients will report their symptoms using this system once at baseline prior to chemotherapy, weekly during the course of treatment.

Phase 2 Study

Patients who are eligible for the study will be recruited in the Thoracic Clinic prior to the initiation of chemotherapy. Patients will be randomly assigned to the experimental (IVR assessment plus triage) or comparison (IVR telephone assessment only) condition. The IVR assessment system will call patients weekly during treatment to assess their symptoms. Every three weeks patients in both groups will be asked to complete measures assessing physical, affective and health-related quality of life during a regular clinic visit.

Measures

The outcome measures include the MD Anderson Symptom Inventory (MDASI), the MOS 12-Item Short-Form Health Survey (SF-12) and the Profile of Mood States (POMS).